Luis Ramon Limchayseng, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

40658 Issued in CA

Practice address

1701 Novato Blvd
Suite 108
Novato, CA 94947-3000

Phone

(415) 892-8613

Fax

(415) 892-0903

NPI assigned

Feb 19, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Apr 16, 2013 through Apr 16, 2027

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902940125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 NOVATO BLVD",
            "address_2": "SUITE 108",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949473000",
            "telephone_number": "415-892-8613",
            "fax_number": "415-892-0903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 NOVATO BLVD",
            "address_2": "SUITE 108",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949473000",
            "telephone_number": "415-892-8613",
            "fax_number": "415-892-0903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIMCHAYSENG",
        "first_name": "LUIS",
        "middle_name": "RAMON",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "40658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marcelle Mae Little, LMFT
• Jennifer Shaw-Chin Liu, FNP

• Oral and Maxillofacial Surgery (Dentist) in Novato, CA
• Providers in Novato, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.